Monday, July 6, 2015

Breastfeeding's best ... but not always easy

There are plenty of great reasons to breastfeed your baby, but that doesn't mean that it will be easy. An expert offers some helpful strategies.

Breastfeeding’s best … but not always easy

(AP Photo/Pat Roque)
(AP Photo/Pat Roque) (AP Photo/Pat Roque)

Breastfeeding moms are standing up for their rights to nurse in public – essential for keeping a hungry baby fed and happy. This past week, “lactivists” staged nurse-ins in Georgia demanding new laws after one pastor insisted a woman stop nursing in church last summer. Moms held over 200 nurse-ins at Target stores across the nation in late December after employees at one store ridiculed a nursing mom.  

While 45 states including Pennsylvania, New Jersey and Delaware specifically allow women to breastfeed in public, not everyone’s comfortable seeing a mom nursing her child on a park bench or at a table in a restaurant. Beyoncé made national news when she nursed 7-week old Blue Ivy at a Manhattan eatery in February. (I attracted zero attention – a good thing - nursing my baby in an Allentown, Pa. Jiffy Lube back in 1999.)

What’s tougher about nursing – and what all this new solidarity may help – are the early weeks. The American Academy of Pediatrics recently re-issued its recommendation that new moms nurse their babies exclusively for six months, and continue breastfeeding after they’ve added in solid foods for the rest of a baby’s first year (and beyond if they wish). There are plenty of great reasons to nurse – including reduced risk for SIDS and ear infections for babies as well as some protection against obesity, heart disease and severe pneumonia as they grow up. Moms get lowered risk for breast, ovarian and uterine cancers. And the two of you feel close.

Yet while 73 percent of women start out breastfeeding, just 14 percent are breastfeeding exclusively at six months. I asked Esther K. Chung, M.D., M.P.H., , breastfeeding advocate and director of the Newborn Nursery at Thomas Jefferson University Hospital, why – and how - expectant moms can prepare for successful nursing. “Breastfeeding is natural but that does not mean that it is easy,” Chung told me.  “The first several weeks are generally the most challenging.”

Challenges include soreness, cracked nipples, a baby who hasn’t learned how to latch on, or one who likes marathon, hour-long feeds.  Timing can be tough, too. Babies need to nurse more often during growth spurts, as well as middle-of-the-night feedings that test your ability to stay awake in a rocking chair at 3 a.m.  “I tell mothers that they are on their way to success if they can exclusively breastfeed for the first 2-3 weeks,” Chung says. But new moms face another set of challenges, too – including going back to work or to school.           

These strategies can help you get a great start – and give your baby one, too:

Take a breastfeeding class: Your local hospital may offer one, or breastfeeding may be part of your childbirth classes.

Line up a lactation consultant.  A trained breastfeeding expert can answer your questions, meet with you to solve breastfeeding problems and support you when times get tough. Your hospital or pediatrician’s office may have one, or check the locater service of the International Lactation Consultant Association.  Check your health insurance – some plans cover this important service.

Talk with your spouse and family. Nursing’s a big commitment of time and energy. A supportive spouse and family can make all the difference

Connect with other breastfeeding moms. “A number of hospitals offer breastfeeding support groups,” Dr. Chung says.  “At Jefferson, we have a breastfeeding support group that meets from 12 to 1 pm on Tuesdays in the Family Medicine Conference Room, 833 Chestnut, 3rd Floor.  For more information, call Parent Education 215-955-6713 or the Lactation Office 215-955-6665.” You’ll also find like-minded moms through the La Leche League International.

Talk to your employer. You can go back to work and continue to nurse, Dr. Chung says. Workplaces with more than 50 employees are required to provide breastfeeding mothers with time and space to express their breast milk while at work – but even if yours is smaller, it’s worth asking. “All working, breastfeeding women should be allowed and encouraged to express breast milk while at work so that they can maintain an adequate supply of milk,” she says.  What you’ll need: A place to pump and time to do it. What to say: “Workplace lactation support programs have been proven to result in higher employee satisfaction, less missed days of work, less attrition, and higher work productivity,” Dr. Chung notes.  “The return on investment is 3:1; for every dollar invested in lactation support, $3 are saved in costs related to missed days of work and caring for children with illness.”  

Chung is also an attending physician at Nemours/Alfred I. duPont Hospital for Children and an associate professor of pediatrics at Thomas Jefferson Medical College.

For those of you who are veteran breast feeders, we have a question. What is the most unusual place you've nursed your child? I've already owned up to a Jiffy Lube. How about you? I'm sure you've got some good experiences to share, as well. Post your responses in the comments section. We'll collect the best for an upcoming blog entry. 

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About this blog
Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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